Monday, November 18, 2013
Amid the current national uproar over the troubles of the Affordable Care Act, it is almost uplifting to hear the deep concern expressed by politicians, pundits, lobbyists and corporate leaders over cancellation of existing health insurance policies. They empathize loudly with the millions of potential victims, whose plight infuriates these worthy observers with fury. They fill hours of television and pages of print with expressions of outrage. Suddenly, everyone in Washington is intensely concerned about Americans losing their health coverage.
The outpouring of noble sentiment would be laudable -- indeed, long overdue -- if only there were reason to believe these protestations are sincere. Sadly, the evidence points in the opposite direction, for a single obvious reason: Millions of people in this country have been losing health insurance for years, resulting in many thousands of serious illnesses, bankruptcies and early deaths. But until insurance cancellations became a political embarrassment for President Barack Obama, the usual right-wing reaction was silence. (Except for that awkward and revealing outburst during the 2012 Republican debates when a live audience howled its approval for the "let him die" plan.)
For anyone who has ever honestly cared about people losing their health coverage -- for instance, Obama or his Democratic predecessor, former President Bill Clinton -- the depressing statistical reality has long been plain. Every day, thousands of Americans leave the rolls of the private insurance industry, almost never voluntarily.
People often forfeit insurance after losing a job, which happened to millions during the Great Recession. At its height, when tea party Republicans were fighting to kill Obamacare in the cradle, more than 44,000 people were losing their health coverage every week. In May 2009, the policy journal Health Affairs published a projection that nearly 7 million Americans would lose coverage by the end of 2010.
People also lose insurance because their providers don't want to pay the cost of a grave illness (having gorged on pricey premiums for years), which has happened to many thousands more. The most recent congressional report on the subject found that three major insurance companies had saved at least $300 million through "rescission" of policies held by 20,000 seriously ill clients, which caused their profits to climb.
Nearly half the population at some point during every decade loses insurance because the cost rises and becomes unaffordable. A report released by the Treasury Department four years ago found that almost half of nonelderly Americans had lived without health coverage at some point between 1997 and 2006, a period of relative prosperity and high employment.
The consequence, as everybody ought to know by now, is that upward of 45 million Americans have gone without health coverage at any given moment since 2007. And the further consequence is that many of those uninsured -- men, women and children -- go without needed health care, leading to untold suffering and premature deaths of as many as 45,000 annually, perhaps more.
But such dismal facts have never seemed to trouble the Republicans who are screaming so loudly now about the terrible toll of Obamacare. The perennial GOP attitude was set forth by neoconservative eminence Bill Kristol back in 1993, when the prime objective was to kill the nascent Clinton health plan. "There is no health care crisis," Kristol famously declared, and for him -- then a well-paid flack in the Rupert Murdoch empire -- that was true enough.
After two decades of medical costs skyrocketing above inflation, threatening fiscal and economic ruin, while millions went without insurance, such smug right-wing complacency remains largely intact. The only "health care crisis" ever feared by Republicans like Kristol is the prospect that reform will help Americans -- as Obamacare is already doing, despite the GOP's best efforts against it.
Let's hope that the president's team swiftly solves the inherent problems of providing universal coverage through private insurers. It is certainly possible, if never optimal, as Massachusetts and other states seeking to advance that goal are already proving.
And meanwhile, let's please have no illusions about this momentary flurry of concern on the right over insurance lost. It would disappear instantly and permanently -- if only Obamacare could be repealed.
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